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Xiang Y, Luo X. Extrapulmonary Comorbidities Associated with Chronic Obstructive Pulmonary Disease: A Review. Int J Chron Obstruct Pulmon Dis 2024; 19:567-578. [PMID: 38476124 PMCID: PMC10927883 DOI: 10.2147/copd.s447739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Most patients with chronic obstructive pulmonary disease (COPD) suffer from at least one additional, clinically relevant chronic disease. To a degree, the high global prevalence and mortality rate of COPD is closely related to its extrapulmonary effects. Moreover, the various of comorbidities of COPD and itself interact with each other, resulting in diverse clinical manifestations and individual differences, and thus further influencing the prognosis as well as healthcare burden of COPD patients. This is closely related to the common risk factors of chronic diseases (aging, smoking, inactivity, etc.). Additionally, some pathophysiological mechanisms caused by COPD, including the systemic inflammatory response, hypoxia, oxidative stress, and others, also have an impact on other systems. But comprehensive management and medical interventions have not yet been established. The clinicians should improve their knowledge and skills in diagnosing as well as treating the comorbidities of COPD, and then aim to develop more individualized, efficient diagnostic and therapeutic strategies for different patients to achieve greater clinical benefits. In this article, we will review the risk factors, mechanisms, and treatment strategies for extrapulmonary comorbidities in chronic obstructive pulmonary disease, including cardiovascular diseases, diabetes, anemia, osteoporosis, emotional disorders, and gastroesophageal reflux disease.
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Affiliation(s)
- Yurong Xiang
- School of Medical and Life Science, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Xiaobin Luo
- Department of Respiratory and Critical Care Medicine, Suining Central Hospital, Suining, Sichuan, 629000, People’s Republic of China
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Pan C, Cheng B, Qin X, Cheng S, Liu L, Yang X, Meng P, Zhang N, He D, Cai Q, Wei W, Hui J, Wen Y, Jia Y, Liu H, Zhang F. Enhanced polygenic risk score incorporating gene-environment interaction suggests the association of major depressive disorder with cardiac and lung function. Brief Bioinform 2024; 25:bbae070. [PMID: 38436562 DOI: 10.1093/bib/bbae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/18/2024] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Depression has been linked to an increased risk of cardiovascular and respiratory diseases; however, its impact on cardiac and lung function remains unclear, especially when accounting for potential gene-environment interactions. METHODS We developed a novel polygenic and gene-environment interaction risk score (PGIRS) integrating the major genetic effect and gene-environment interaction effect of depression-associated loci. The single nucleotide polymorphisms (SNPs) demonstrating major genetic effect or environmental interaction effect were obtained from genome-wide SNP association and SNP-environment interaction analyses of depression. We then calculated the depression PGIRS for non-depressed individuals, using smoking and alcohol consumption as environmental factors. Using linear regression analysis, we assessed the associations of PGIRS and conventional polygenic risk score (PRS) with lung function (N = 42 886) and cardiac function (N = 1791) in the subjects with or without exposing to smoking and alcohol drinking. RESULTS We detected significant associations of depression PGIRS with cardiac and lung function, contrary to conventional depression PRS. Among smokers, forced vital capacity exhibited a negative association with PGIRS (β = -0.037, FDR = 1.00 × 10-8), contrasting with no significant association with PRS (β = -0.002, FDR = 0.943). In drinkers, we observed a positive association between cardiac index with PGIRS (β = 0.088, FDR = 0.010), whereas no such association was found with PRS (β = 0.040, FDR = 0.265). Notably, in individuals who both smoked and drank, forced expiratory volume in 1-second demonstrated a negative association with PGIRS (β = -0.042, FDR = 6.30 × 10-9), but not with PRS (β = -0.003, FDR = 0.857). CONCLUSIONS Our findings underscore the profound impact of depression on cardiac and lung function, highlighting the enhanced efficacy of considering gene-environment interactions in PRS-based studies.
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Affiliation(s)
- Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Xiaoyue Qin
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Na Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Dan He
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Qingqing Cai
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Jingni Hui
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Huan Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
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Zhao X, Liu G, Liu D, Zou L, Huang Q, Chen M, Li D, Wu B, Wu H, Huang D, Wu D. Clinical and economic burden of anxiety/depression among older adult COPD patients: evidence from the COPD-AD China Registry study. Front Psychiatry 2024; 14:1221767. [PMID: 38260779 PMCID: PMC10800442 DOI: 10.3389/fpsyt.2023.1221767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Background Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), especially older adult patients. This can complicate the disease progression and lead to increased clinical and economic burden. We sought to investigate the clinical and economic burdens associated with the presence of anxious and/or depressive symptoms among older adult COPD patients. Methods We screened 579 patients aged over 60 years and diagnosed with COPD via a lung function test following the 2017 Global Initiative Chronic Obstructive Lung Disease (GOLD) guidelines. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS) through face-to-face interviews at admission. Follow-up was conducted by telephone calls at 6, 12, 18, 24, and 36 months after discharge to assess clinical and economic burden. COPD-anxiety and/or depression patients were matched to patients without anxiety and depression (COPD-only) using propensity scores. Multivariate regression models were used to compare clinical and economic burden between COPD-anxiety and/or depression and COPD-only groups. Results Compared with COPD-only patients, COPD patients complicated with anxiety and/or depression had increased clinical burden, including higher COPD-related outpatient visits, COPD-related hospitalizations, and length of COPD-related hospitalizations (p < 0.001). Moreover, they also had an increased economic burden, including higher annual total healthcare costs, medical costs, and pharmacy costs (p < 0.001). Conclusion Older adult COPD patients with anxiety or depression had significantly higher clinical and economic burdens than patients without these comorbidities. These findings deserve further exploration and may be useful for the formulation of relevant healthcare policies.
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Affiliation(s)
- Xuanna Zhao
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Gege Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- First College for Clinical Medicine, Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Dewei Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- First College for Clinical Medicine, Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Li Zou
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Qiu Huang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Min Chen
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Dongming Li
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Bin Wu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Hua Wu
- Department of Information Technology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Dan Huang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Dong Wu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
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Kham-Ai P, Heaton K, Xiao C, Wheeler P. Systematic Review and Meta-Analysis of Psychological Distress and Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Consequences. Nurs Res 2024; 73:62-71. [PMID: 37768970 DOI: 10.1097/nnr.0000000000000694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND People with chronic obstructive pulmonary disease (COPD) occasionally develop acute exacerbation of COPD-a potentially fatal condition. Psychological distress was associated with acute exacerbation of COPD. However, the evidence on the effect of psychological distress on acute exacerbation of COPD remains unclear. OBJECTIVE The aim of this study was to explore the influence of psychological distress on acute exacerbation of COPD and its consequences. METHODS The current review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using three databases (PubMed, CINAHL, and PsyINFO) that were searched to identify relevant articles. Pooled risk ratios and 95% confidential interval were calculated from the included studies' data with random-effect methods to estimate the effect of psychological distress on acute exacerbation of COPD and its consequences. RESULTS Nineteen articles were included in the review. Most revealed that psychological distress was significantly associated with increased risk of acute exacerbation of COPD and its consequences. The meta-analyses showed that psychological distress increased risk of acute exacerbation of COPD, COPD-related hospitalization, and death. CONCLUSION Psychological distress had negative effects on acute exacerbation of COPD and its consequences. The results of the meta-analyses show that persons with COPD and psychological distress had a greater risk of acute exacerbation of COPD, hospitalization, and death.
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Tang T, Li Z, Lu X, Du J. Development and validation of a risk prediction model for anxiety or depression among patients with chronic obstructive pulmonary disease between 2018 and 2020. Ann Med 2022; 54:2181-2190. [PMID: 35916588 PMCID: PMC9351569 DOI: 10.1080/07853890.2022.2105394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Anxiety and depression are important risk factors for chronic obstructive pulmonary disease (COPD). The aim of this study was to develop a prediction model to predict anxiety or depression in COPD patients. The retrospective study was conducted in COPD patients receiving stable treatment between 2018 and 2020 to develop prediction model. The variables, were readily available in clinical practice, were analysed. After data preprocessing, model training and performance evaluation were performed. Validity of the prediction model was verified in 3 comparative model training. Between 2018 and 2020, 375 eligible patients were analysed. Thirteen variables were included into the final model: gender, age, marital status, education level, long-term residence, per capita annual household income, payment method of medical expenses, direct economic costs of treating COPD in the past year, smoking, COPD progression, number of acute exacerbation of COPD in the last year, regular treatment with inhalants and family oxygen therapy. Risk score threshold in each sample in the training set was 1.414. The area under the curve value was respectively 0.763 and 0.702 in the training set and test set, which were higher than three comparative models. The simple prediction model to predict anxiety or depression in patients with COPD has been developed. Based on 13 available data in clinical indicators, the model may serve as an instrument for clinical decision-making for COPD patients who may have anxiety or depression.Key messagesThirteen variables were included into the prediction model.The AUC value was, respectively, 0.763 and 0.702 in the training set and test set, which were higher than three comparative models.The simple prediction model to predict anxiety or depression in patients with COPD has been developed.
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Affiliation(s)
- Tingyu Tang
- Department of Respiratory Medicine, Zhejiang Hospital, Hangzhou, China
| | - Zongju Li
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoling Lu
- Department of Respiratory Medicine, Zhejiang Hospital, Hangzhou, China
| | - Jianzong Du
- Department of Respiratory Medicine, Zhejiang Hospital, Hangzhou, China
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Symptoms of depression, anxiety and stress in patients with chronic otitis media. PLoS One 2022; 17:e0270793. [PMID: 35776729 PMCID: PMC9249177 DOI: 10.1371/journal.pone.0270793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Persistent symptoms of chronic otitis media cause limitations in daily routine and social interactions, influencing significantly patients’ quality of life and mental health. The purpose of the study was to assess the intensity depression, anxiety and stress symptoms in patients with chronic otitis media and to examine if patient demographic data, characteristics and reported symptoms of otitis influence reported depression, anxiety and stress symptoms. Material and methods The study included 316 adult patients diagnosed with unilateral or bilateral chronic otitis media with or without cholesteatoma. Patients underwent a complete otological, audiological and radiological assessment. Chronic otitis media questionnaire 12 (COMQ-12) was used to assess the impact of COM and Depression Anxiety Stress Scale 21 (DASS-21) was used for depression, anxiety and stress assessment. Results Some level of anxiety and stress were detected in 70.57% 49.37% of the patients, respectively. 13.29% of the patients had scores indicating depression disorder. The mean value of the COMQ-12 questionnaire for this group of patients was 26.24 (SD±11.47) More intense symptoms of COM were significantly associated (p<0.05) with higher scores on DASS-21 subscales. Multivariate logistic regression analysis indicated that significant positive predictors of higher anxiety scores were pure tone average (PTA) on better and worse hearing ear (p<0.05). Drainage from the ear, hearing problems at home and tinnitus were significant positive predictors of a higher DASS-depression score. (p<0.05) Conclusion The study confirmed positive correlation between reported level of anxiety, depression and stress, severity of COM symptoms and quality of life. Level of hearing on the better and worse hearing ear were significant positive predictors of anxiety and stress in patients with COM.
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Fei F, Koffman J, Zhang X, Gao W. Synergistic Impact of the Symptom Cluster on Health-Related Quality of Life in Patients With Chronic Obstructive Pulmonary Disease: A Secondary Data Analysis. Clin Nurs Res 2022; 31:991-999. [PMID: 35362332 PMCID: PMC9266057 DOI: 10.1177/10547738221085765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to quantify the synergistic impact of symptom clusters on health-related quality of life (HRQoL) among patients with chronic obstructive pulmonary disease (COPD). We conducted a secondary analysis of a cross-sectional data collected via convenience sampling from patients with COPD. Multiple linear regressions were used to quantify the relationships between symptom clusters and HRQoL. The sample included 106 COPD patients from whom three symptom clusters were identified comprising of dyspnea depression, anxiety-sleep, and depression-anxiety. Depression-anxiety (psychological symptom cluster) was significantly associated with poorer HRQoL (β = 13.88, 95% CI [7.94, 19.82]), while no significant associations were detected with HRQoL for either depression or anxiety alone (β = 6.66, 95% CI [-2.99, 16.31]; β = 7.29, 95% CI [-0.78, 15.35]). Assessment and early intervention led by nurses targeting the psychological symptom cluster may represent an initial approach to improve HRQoL. Understanding the phenomenon of symptom clusters that are present in patients with COPD provides a breakthrough insight to devise strategies for their management.
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Affiliation(s)
- Fei Fei
- King's College London, UK.,Jiangsu College of Nursing, Huai'an, P.R. China
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Lokesh KS, Rao AA, Chaya SK, Jayaraj BS, Praveena AS, Krishna M, Madhivanan P, Padukudru Anand M. Associations of Vitamin D, chronic obstructive pulmonary disease and acute exacerbations of COPD with anxiety and depression: a nested case control study. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17439.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Lower vitamin D levels have not only been associated with chronic obstructive pulmonary disease (COPD), exacerbations and lower lung functions, but also with anxiety and depression. We examined the associations of severity of anxiety and depression using HAM-A (Hamilton Anxiety Rating Scale) and HAM-D (Hamilton Depression Rating Scale) scores with COPD and vitamin D levels. Methods: Observational nested case control study was conducted in MUDHRA cohort. One hundred COPD subjects and 100 age- gender- matched non-COPD subjects (controls) underwent evaluation of socioeconomic status, respiratory symptoms, spirometry, severity of anxiety and depression, six minute walk test and estimation of serum vitamin D levels. Independent association of low vitamin D levels with severity of anxiety and depression was assessed by logistic regression. Results: COPD group had higher mean±SD anxiety and depression scores (HAM-A 8.0±3.5, HAM-D 8.72±4) compared to control group (HAM-A 4.51±2.2, HAM-D 4.3±2). The COPD group had 53 subjects with mild/moderate anxiety/depression whereas control group had 16 subjects with mild/moderate anxiety/depression. In COPD group, subjects with mild/moderate anxiety/depression had lower vitamin D levels compared to subjects with no/minimal anxiety/depression, while the difference in control group was not significant. In logistic regression, anxiety and depression levels had independent association with vitamin D levels, lung function variables, six-minute walk distance and presence of COPD. In COPD subgroup, anxiety and depression levels had independent association with breathlessness, GOLD FEV1 staging, CAT score, SGRQ-C Symptom score and exacerbation of COPD. Conclusions: Greater proportion of COPD subjects suffer from anxiety and depression as compared to subjects without COPD. Severity of anxiety and depression was greater in COPD subjects. Poorer lung functions, higher respiratory symptoms and lower vitamin D levels are associated with higher levels of anxiety and depression in COPD subjects. There is an urgent need to recognise anxiety and depression in COPD patients.
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Jenkins CR. Towards precision in defining COPD exacerbations. Breathe (Sheff) 2021; 17:210081. [PMID: 35035551 PMCID: PMC8753624 DOI: 10.1183/20734735.0081-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022] Open
Abstract
COPD is the most prevalent chronic respiratory disease worldwide and a major cause of disability and death. Acute exacerbations of COPD remain a key feature of the disease in many patients and research assessing interventions to prevent and treat them requires a robust definition with high sensitivity and specificity. To date, no such definition exists, and multiple different definitions are used in clinical studies depending on the research question. The strengths and weaknesses of current definitions are discussed in the context of evolving knowledge and different settings in which studies are undertaken. Whether identification and recording of exacerbations remains essentially clinical, or can be identified with a dependable biomarker, it should be sensitive and adaptable to context while retaining clarity and facilitating data collection. This is essential to progress a better understanding of the pathophysiology and phenotypic expression of exacerbations to reduce their impact and personal burden for patients.
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Affiliation(s)
- Christine R. Jenkins
- Respiratory Group, The George Institute for Global Health, Sydney, Australia
- UNSW Sydney, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
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de la Cruz SP, Cebrino J. Common Mental Disorders, Functional Limitation and Diet Quality Trends and Related Factors among COPD Patients in Spain, 2006-2017: Evidence from Spanish National Health Surveys. J Clin Med 2021; 10:jcm10112291. [PMID: 34070391 PMCID: PMC8197509 DOI: 10.3390/jcm10112291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
Certain conditions such as common mental disorders (CMDs), functional limitation (FL) and poor diet quality may affect the lives of individuals who suffer from chronic obstructive pulmonary disease (COPD). This study sought to examine time trends in the prevalence of CMDs, FL and diet quality among male and female COPD patients living in Spain from 2006 to 2017 and to identify which factors were related to CMDs, FL and a poor/improvable diet quality in these patients. We performed a cross-sectional study among COPD patients aged ≥ 40 years old using data from the Spanish National Health Surveys conducted in 2006, 2011 and 2017, identifying a total of 2572 COPD patients. Binary logistic regressions were performed to determine the characteristics related to CMDs, FL and poor/improvable diet quality. Over the years of the study, the prevalence of FL among female COPD patients increased (p for trend <0.001). In addition, CMDs were associated to body mass index (BMI), educational level, physical activity, smoking status, occupation, chronic conditions and alcohol consumption; FL was related to age, living with a partner, educational level, physical activity and chronic conditions; and poor/improvable diet quality was associated to age, smoking status, BMI and physical activity.
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Affiliation(s)
- Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, Avda. Menéndez Pidal, S/N, 14071 Córdoba, Spain;
| | - Jesús Cebrino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Doctor Fedriani, S/N, 41009 Seville, Spain
- Correspondence: ; Tel.: +34-954-551-771
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Martucci VL, Richmond B, Davis LK, Blackwell TS, Cox NJ, Samuels D, Velez Edwards D, Aldrich MC. Fate or coincidence: do COPD and major depression share genetic risk factors? Hum Mol Genet 2021; 30:619-628. [PMID: 33704461 PMCID: PMC8120137 DOI: 10.1093/hmg/ddab068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/24/2021] [Accepted: 02/27/2021] [Indexed: 01/12/2023] Open
Abstract
Major depressive disorder (MDD) is a common comorbidity in chronic obstructive pulmonary disease (COPD), affecting up to 57% of patients with COPD. Although the comorbidity of COPD and MDD is well established, the causal relationship between these two diseases is unclear. A large-scale electronic health record clinical biobank and genome-wide association study summary statistics for MDD and lung function traits were used to investigate potential shared underlying genetic susceptibility between COPD and MDD. Linkage disequilibrium score regression was used to estimate genetic correlation between phenotypes. Polygenic risk scores (PRS) for MDD and lung function traits were developed and used to perform a phenome-wide association study (PheWAS). Multi-trait-based conditional and joint analysis identified single-nucleotide polymorphisms (SNPs) influencing both lung function and MDD. We found genetic correlations between MDD and all lung function traits were small and not statistically significant. A PRS-MDD was significantly associated with an increased risk of COPD in a PheWAS [odds ratio (OR) = 1.12, 95% confidence interval (CI): 1.09-1.16] when adjusting for age, sex and genetic ancestry, but this relationship became attenuated when controlling for smoking history (OR = 1.08, 95% CI: 1.04-1.13). No significant associations were found between the lung function PRS and MDD. Multi-trait-based conditional and joint analysis identified three SNPs that may contribute to both traits, two of which were previously associated with mood disorders and COPD. Our findings suggest that the observed relationship between COPD and MDD may not be driven by a strong shared genetic architecture.
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Affiliation(s)
- Victoria L Martucci
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Bradley Richmond
- Department of Veterans Affairs Medical Center, Nashville, TN 37212, USA
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Lea K Davis
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Timothy S Blackwell
- Department of Veterans Affairs Medical Center, Nashville, TN 37212, USA
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Nancy J Cox
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - David Samuels
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Digna Velez Edwards
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Melinda C Aldrich
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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12
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Evaluation of Hospital Admission Status for Emergency Department Patients Seen for Chronic Obstructive Pulmonary Disease Exacerbation: A Retrospective Observational Study. Ochsner J 2021; 21:19-24. [PMID: 33828422 PMCID: PMC7993420 DOI: 10.31486/toj.19.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a common and preventable condition. The disease accounts for a large economic burden in the US health care system. Better control and prevention of COPD exacerbations can help prevent presentations to already-crowded emergency departments (EDs) and hospitals. The objective of our study was to identify variables associated with hospital admission status in ED patients presenting with COPD exacerbation. Methods: We conducted a retrospective observational study of patients seen at 1 of 3 US EDs from 2012 to 2014 with a primary diagnosis related to COPD exacerbation. Hospital admission status was modeled using patient characteristic data via adaptive least absolute shrinkage and selection operator logistic regression. Study results are presented as adjusted odds ratios with 95% CIs. Planned post hoc model dependency and external data sensitivity analyses were conducted. Results: The study sample included 1,165 unique patients with COPD with an ED encounter related to exacerbation at 1 of the 3 reviewed hospitals. Approximately half of these patients had a hospital admission. Variables inversely associated with an admission included oxygen saturation and number of prior ED encounters for COPD exacerbation. Variables positively associated with admission were initial ED heart rate, patient age, and documented comorbidities of anxiety and/or depression. These mental health comorbidities had the strongest association with admission status. Conclusion: Understanding the characteristics of admitted patients may help direct resources and outpatient services to prevent encounters. Of note, the study revealed mental health variables as being strongly associated with admission status.
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13
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Fischer BC, Schulz KT, Wiemann M, Lücke E, Schreiber J. [Studies on Factors Influencing Influenza Vaccination Rates in Patients with Chronic Obstructive Pulmonary Disease]. Pneumologie 2020; 75:499-506. [PMID: 32927490 DOI: 10.1055/a-1180-0111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND : With low influenza vaccination rates among the chronically ill, approaches to increase these rates among risk patients with chronic obstructive pulmonary disease (COPD) are to be uncovered. METHODS : 120 COPD patients from Magdeburg filled out a questionnaire and were analyzed regarding the influenza vaccination status 2015/2016 or 2016/2017. Vaccinated and unvaccinated were compared in socio-epidemiological factors, the health belief model (HBM), self-efficacy (GESIS-ASKU), anxiety/depression (HADS-D) and disease processing (FKV-LIS). RESULTS : 62.5 % (n = 75) were vaccinated, 31.7 % (n = 38) unvaccinated, 5.8 % (n = 7) made no statement. In over or equal to 60-year-olds 76 % were vaccinated, in under 60-year-olds 42 % were vaccinated. 60 % (n = 72) knew to belong to a risk group. Unvaccinated indicated greater concern about side effects of the vaccination (p = .004) and drew a worse benefit-expense balance (p = .001). Unvaccinated were more often uncertain about the vaccination protection and the severity of influenza (p ≤ .001). Vaccinated were highly motivated to think about vaccination themselves and more often had a positive vaccination history (p = .001). COPD patients showed a lower self-efficacy than the reference group of the German general population (p = .000), vaccinated and unvaccinated did not differ (p = .418). No difference between vaccinated and unvaccinated was found in the processing of the disease and in depression and anxiety, but unvaccinated tended to give higher anxiety values. CONCLUSION : Measures should particularly target COPD patients under 60 years of age with a negative vaccination history and sensitize them as risk patients. Widespread uncertainties about the severity of influenza and vaccination protection should be addressed. It should be communicated that influenza vaccination does not lead to exacerbation. The vaccination recommendation should increasingly be made by pulmonologists.
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Affiliation(s)
- B C Fischer
- Universitätsklinik für Pneumologie, Universitätsklinikum der Otto-von-Guericke-Universität Magdeburg.,Klinik für Pneumologie, Medizinische Hochschule Hannover
| | | | | | - E Lücke
- Universitätsklinik für Pneumologie, Universitätsklinikum der Otto-von-Guericke-Universität Magdeburg
| | - J Schreiber
- Universitätsklinik für Pneumologie, Universitätsklinikum der Otto-von-Guericke-Universität Magdeburg
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14
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Lin TF, Shune S. Chronic Obstructive Pulmonary Disease and Dysphagia: A Synergistic Review. Geriatrics (Basel) 2020; 5:geriatrics5030045. [PMID: 32847110 PMCID: PMC7554843 DOI: 10.3390/geriatrics5030045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 01/21/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading global cause of death and disability. The literature has previously established clear physiological characteristics of COPD-related dysphagia (swallowing difficulties). However, COPD and dysphagia are both also intimately tied to breathing and contribute to a cascade of secondary physio-psycho-emotional sequalae, such as COPD exacerbation, anxiety, depression, increased economic burden, social isolation, and decreased quality of life. Further, the collective impact of these comorbidities may magnify disease impact, resulting in a downward spiral of well-being. Thus, the clinical relevance of COPD’s and dysphagia’s frequently occurring and overlapping sequelae cannot be overlooked, as the disease-related burden of both disorders is deeply rooted in the presence of concomitant physiological and psycho-emotional consequences. The current review explores the complex network of interactions between COPD, dysphagia, and their outcomes, framing this relationship within a mind-body-breath framework. Ultimately, we propose a model that more comprehensively captures the constellation of interrelated disease characteristics and consequences, highlighting a need for researchers and healthcare providers to consider disease impact more broadly in order to maximize treatment outcomes.
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15
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ILIE AC, CRIŞAN A, HOGEA STANCA P, TRĂILĂ D. Effectiveness of pulmonary rehabilitation in improving quality of life in patients with different COPD stages. BALNEO RESEARCH JOURNAL 2020. [DOI: 10.12680/balneo.2020.307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Anxiety and depression are frequently associated conditions in COPD patients, and have also significant impact on their quality of life (QoL) and on the course of the disease. Pulmonary rehabilitation (PR) is an adjuvant, non-pharmacological method used in symptomatic COPD patients. The study aimed to evaluate the impact of COPD on QoL depending on disease severity, and to assess the supposedly positive effects of a pulmonary rehabilitation program (PRP) for COPD patients. Material and method. This research included patients with COPD GOLD stages II-IV undergoing bronchodilator therapy. QoL was assessed with the self-administered St George's Respiratory Questionnaire (SGRQ), and depression with the Beck Depression Inventory (BDI). PRP included 3-5 weekly physical training sessions for an average period of 12 weeks, but not less than 3 weeks. Results. The degree of QoL impairment was moderate in stage II (41.07) and severe in stages III (70.28) and IV (81.02). The most severe depression (score 26.6 vs 2.5 in healthy subjects) was also recorded in this group. After the patients underwent all PRP, QoL reassessment at 6 months revealed statistically significant improvements in all 3 groups (p <0.05). In the GOLD COPD stage II group the average reduction was -4.38 units, in the group GOLD COPD stage III -5.37 units, and in the GOLD COPD stage IV -6.75 units. The depression score correlated with the SGRQ score, both of them being higher in the severe stages of disease. BDI administered again 6 months after PRP revealed a significant improvement in average score in all groups, respectively a decrease of -2.17 units in the COPD II group, -2.03 units in the COPD III group and -1.88 units in group COPD IV B group. Conclusion. The results of this study demonstrate a favorable impact of PRP on improving COPD associated symptoms, depression, and QoL in all the 3 monitored COPD patient groups, with statistically significant and persistent positive results over time (6 months after completion of PRP).
Key words: COPD, pulmonary rehabilitation program, Quality of life (QoL), depression,
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Affiliation(s)
| | - Alexandru CRIŞAN
- “Victor Babeş”University of Medicine and Pharmacy, Timişoara, Romania
| | | | - Daniel TRĂILĂ
- “Victor Babeş”University of Medicine and Pharmacy, Timişoara, Romania
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16
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Wang L, Meng J, Wang C, Yang C, Wang Y, Li Y, Li Y. Hydrogen sulfide alleviates cigarette smoke-induced COPD through inhibition of the TGF- β1/smad pathway. Exp Biol Med (Maywood) 2020; 245:190-200. [PMID: 32008357 DOI: 10.1177/1535370220904342] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Smoking has become a major cause of chronic obstructive pulmonary disease through weakening of the respiratory mucus-ciliary transport system, impairing cough reflex sensitivity, and inducing inflammation. Recent researches have indicated that hydrogen sulfide is essential in the development of various lung diseases. However, the effect and mechanism of hydrogen sulfide on cigarette smoke-induced chronic obstructive pulmonary disease have not been reported. In this study, rats were treated with cigarette smoke to create a chronic obstructive pulmonary disease model followed by treatment with a low concentration of hydrogen sulfide. Pulmonary function, histopathological appearance, lung edema, permeability, airway remodeling indicators, oxidative products/antioxidases levels, inflammatory factors in lung, cell classification in bronchoalveolar lavage fluid were measured to examine the effect of hydrogen sulfide on chronic obstructive pulmonary disease model. The results showed that hydrogen sulfide effectively improved pulmonary function and reduced histopathological changes, lung edema, and permeability. Airway remodeling, oxidative stress, and inflammation were also reduced by hydrogen sulfide treatment. To understand the mechanisms, we measured the expression of TGF-β1, TGF-βIand TGF-βII receptors and Smad7 and phosphorylation of Smad2/Smad3. The results indicated that the TGF-β1 and Smad were activated in cigarette smoke-induced chronic obstructive pulmonary disease model, but inhibited by hydrogen sulfide. In conclusion, this study showed that hydrogen sulfide treatment alleviated cigarette smoke-induced chronic obstructive pulmonary disease through inhibition of the TGF-β1/Smad pathway. Impact statement COPD has become a severe public health issue in the world and smoking has become a major cause of COPD. As a result, it is a demandingly needed to explore new potential therapy for cigarette smoke-associated COPD. The present study suggested that H2S treatment improved pulmonary function and reduced histopathological changes, lung edema, permeability, inflammation, airway remodeling and oxidative injury in a COPD model induced by cigarette smoke. Although additional studies are required to elucidate the pharmacodynamics, pharmacokinetics, and pharmacology of H2S in the cigarette smoke-associated COPD, our findings provide an experimental basis for the potential clinical application of H2S in COPD treatment.
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Affiliation(s)
- Liang Wang
- Department of Respiratory and Critical Care, Hebei Chest Hospital, Hebei 050048, China
| | - Jing Meng
- Department of Respiratory and Critical Care, Hebei Chest Hospital, Hebei 050048, China
| | - Caicai Wang
- Department of Respiratory and Critical Care, Hebei Chest Hospital, Hebei 050048, China
| | - Chao Yang
- Department of Gynecology, Shijiazhuang Second Hospital, Shijiazhuang 050048, China
| | - Yuan Wang
- Department of Respiratory and Critical Care, Hebei Chest Hospital, Hebei 050048, China
| | - Yamei Li
- Department of Respiratory and Critical Care, Hebei Chest Hospital, Hebei 050048, China
| | - Yujing Li
- Department of Laboratory, Hebei Chest Hospital, Hebei 050048, China
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17
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Lim JU, Park CK, Kim TH, Jang AS, Park YB, Rhee CK, Jung KS, Yoo KH, Lee WY, Yoon HK. The Difficulty Of Improving Quality Of Life In COPD Patients With Depression And Associated Factors. Int J Chron Obstruct Pulmon Dis 2019; 14:2331-2341. [PMID: 31632002 PMCID: PMC6790330 DOI: 10.2147/copd.s216746] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/16/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives Depression is a major comorbidity that affects clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). COPD patients with depression are hospitalized more frequently, and show more acute exacerbations, decreased physical and social activities, and higher mortality compared to their non-depressed counterparts. In the present study, we investigated the clinical impact of depressive symptoms and associated clinical factors in Korean patients with COPD by evaluating multicenter cohort data. Materials and methods Patients with COPD enrolled in the Korean COPD Subtype Study, a multicenter observational study, from December 2011 to October 2014 were selected for evaluation. The initial evaluation of all patients included pulmonary function tests, 6 min walk distance (6MWD), the COPD Assessment Test (CAT), and the COPD-specific version of the St. George’s Respiratory Questionnaire (SGRQ-C). Significant depression was defined as a Beck Depression Inventory-II (BDI-II) score ≥17. Results Among the 270 study patients, 19.6% had significant depression. The depressed group showed a higher proportion of females (41.4%), lower body mass index (BMI), and lower education level compared to the non-depressed group (p = 0.002, p = 0.008, and p = 0.019, respectively). The depressed group had significantly higher CAT and SGRQ-C scores, as well as a lower 6MWD, compared to the non-depressed group based on 6 month-interval serial measurements over 3 years. The total SGRQ-C score and the symptoms, activity, and impact domain scores were significant predictors of depression (area under curves [AUCs] of 0.699 [0.613–0.786], 0.670 [0.581–0.758], 0.680 [0.589–0.770], and 0.689 [0.603–0.776], respectively). From CAT score domains, sleep and energy scores were significant predictors of depression (AUCs of 0.619 [0.522–0.715] and 0.595 [0.504–0.685], respectively). SGRQ-C score, low BMI, and decreased 6MWD were significantly associated with depression in a multivariable analysis. Conclusion A considerable proportion of patients with COPD had depression, and a high SGRQ-C score, low BMI, and low 6MWD were significantly associated with depression. As improving quality of life in this subgroup is difficult, physicians should be more active in screening patients with significant depression.
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Affiliation(s)
- Jeong Uk Lim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kwon Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Hyung Kim
- Division of Pulmonary and Critical Care Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - An-Soo Jang
- Division of Respiratory and Allergy, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Yong Bum Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki Suck Jung
- Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang, Republic of Korea
| | - Kwang Ha Yoo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Won-Yeon Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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18
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Mackay AJ, Kostikas K, Murray L, Martinez FJ, Miravitlles M, Donaldson G, Banerji D, Patalano F, Wedzicha JA. Patient-reported Outcomes for the Detection, Quantification, and Evaluation of Chronic Obstructive Pulmonary Disease Exacerbations. Am J Respir Crit Care Med 2018; 198:730-738. [DOI: 10.1164/rccm.201712-2482ci] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Alex J. Mackay
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- European Respiratory Society Fellowship in Industry, Novartis Campus, Basel, Switzerland
| | | | | | | | - Marc Miravitlles
- Hospital Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, España; and
| | - Gavin Donaldson
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Donald Banerji
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | | | - Jadwiga A. Wedzicha
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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Test Performance Characteristics of the AIR, GAD-7, and HADS-Anxiety Screening Questionnaires for Anxiety in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2018; 15:926-934. [PMID: 29986152 DOI: 10.1513/annalsats.201708-631oc] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Rationale: Anxiety is a common comorbidity of chronic obstructive pulmonary disease (COPD) that is associated with higher morbidity and mortality. We evaluated three anxiety screening questionnaires: the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), and the Anxiety Inventory for Respiratory Disease (AIR).Objectives: To evaluate and compare the test performance characteristics of three anxiety screening questionnaires, using the Mini-International Neuropsychiatric Interview (MINI), version 7.0, as the "gold standard."Methods: Individuals with COPD were recruited at 16 centers. The MINI and questionnaires were administered by trained research coordinators at an in-person visit and readministered by telephone 2-4 weeks later. A composite score for the presence of any Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) anxiety disorder was computed, based on the MINI as the gold standard, compared with a participant screening positive on self-report measures for these analyses.Results: Two hundred and twenty eligible individuals with COPD were enrolled; 219 completed the study. Eleven percent were identified as having a DSM-V anxiety disorder, based on the MINI. Elevated anxiety symptoms based on questionnaires were 38% for the AIR, 30% for the GAD-7, and 20% for the HADS-A. Area under the receiver operating characteristic curve (AUC) was highest for the GAD-7 (0.78; 95% confidence interval [CI], 0.69-0.87), followed by the HADS-A (0.74; 95% CI, 0.64-0.84) and the AIR (0.66; 95% CI, 0.56-0.76). The AUC for the GAD-7 was significantly greater than for the AIR (P = 0.014). Sensitivity was not statistically different among the questionnaires: 77% for the GAD-7, 63% for the HADS-A, and 66% for the AIR. The HADS-A had the highest specificity, 85%, which was significantly higher than that of the GAD-7 (77%; P < 0.001) and the AIR (65%; P < 0.001); GAD-7 specificity was higher than AIR specificity (P < 0.001).Conclusions: Symptoms of anxiety among patients with COPD as identified by screening questionnaires were common and significantly higher than the prevalence of anxiety disorder meeting DSM-V criteria. The GAD-7, the HADS-A and the AIR questionnaires had fair to moderate psychometric properties as screening tools for anxiety in individuals with COPD, indicating the need for improved measures for this patient population.
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Underner M, Cuvelier A, Peiffer G, Perriot J, Jaafari N. Influence de l’anxiété et de la dépression sur les exacerbations au cours de la BPCO. Rev Mal Respir 2018; 35:604-625. [PMID: 29937312 DOI: 10.1016/j.rmr.2018.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/13/2018] [Indexed: 02/05/2023]
Affiliation(s)
- M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur CS 10587, 86021 Poitiers cedex, France.
| | - A Cuvelier
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, centre hospitalier universitaire de Rouen, 76031 Rouen, France; Université de Rouen-Normandie, UPRES EA3830 groupe de recherche sur le handicap ventilatoire (GRHV), Institut de recherche et d'innovation biomédicale (IRIB), 76000 Rouen, France
| | - G Peiffer
- Service de pneumologie, centre hospitalier régional Metz-Thionville, 57038 Metz, France
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur CS 10587, 86021 Poitiers cedex, France
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21
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Crespo-Lessmann A, Plaza V, González-Barcala FJ, Fernández-Sánchez T, Sastre J. Concordance of opinions between patients and physicians and their relationship with symptomatic control and future risk in patients with moderate-severe asthma. BMJ Open Respir Res 2017; 4:e000189. [PMID: 29018525 PMCID: PMC5604707 DOI: 10.1136/bmjresp-2017-000189] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/26/2017] [Accepted: 08/09/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction Differences between the opinions of patients and physicians on the impact of asthma are common. We hypothesised that patient–physician discordance may negatively affect asthma outcome. Methods A total of 2902 patients (61% women, mean age 47 years) with moderate–severe asthma and 231 physicians participated in a prospective study. At the baseline visit, data on demographics, clinical variables, degree of asthma control according to the Asthma Control Test (ACT), basic spirometry and the Hospital Anxiety and Depression Scale (HADS) were collected and an ad hoc questionnaire was completed that allowed the degree of concordance between doctors and patients to be assessed. A scheduled telephone call after 3 months was used to elicit the ACT score and the future risk of asthma. At the final visit at 6 months, the following data were recorded: ACT score, spirometry, HADS score and an ad hoc questionnaire to assess the agreement between the doctor and the patient. Changes in study variables according to patient–physician concordance or discordance were analysed. Results The rate of patient–physician discordance was 27.2%, with overestimation of disease impact by the physician in 12.3% and underestimation in 14.9%. Patient–physician opinion discordance, particularly in the case of physicians underestimating the impact of asthma, showed worse results with statistically significant differences in ACT score, a higher percentage of patients with poor asthma control and lower HADS scores. The need for hospital and emergency department admissions was also higher. Conclusion Patient–physician opinion discordance may be contributing to lower symptomatic control and increased future risk, with a higher impact when physicians underestimate the impact of asthma on their patients.
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Affiliation(s)
- Astrid Crespo-Lessmann
- Service of Pneumology, Hospital de la Santa Ceu i Sant Pau, Institute of Sant Pau & Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Vicente Plaza
- Service of Pneumology, Hospital de la Santa Ceu i Sant Pau, Institute of Sant Pau & Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Francisco-Javier González-Barcala
- Service of Pneumology, Complejo Hospitalario Universitario de Santiago de Compostela. Department of Medicine, University of Santiago de Compostela. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
| | | | - Joaquín Sastre
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz. Centro deInvestigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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